Preparing Fourth-Year Medical Students to Teach During Internship by Haber, Bardach, Vedanthan, et al.
Andy Biedlingmaier, Tufts M18 Student on Medical Education Elective
An important responsibility of the medical intern is to teach medical students, however new interns are not always prepared to assume the role of teacher. There is a lack of training in teaching techniques at the medical school level, and courses in education are usually elective (i.e., not mandatory) for students.
The medical school in this article sought to fill this knowledge gap by creating a mandatory course at the end of fourth year composed of four, one-hour classroom sessions over two separate afternoons. The sessions were as follows:
Session 1: Promoting understanding and retention in the clinical setting
Format: Lecture with modeled behavior by speaker
Content: Understand that clinical teaching occurs through small, incremental transfer of knowledge over many “teachable moments” throughout the day
Session 2: Evaluating students fairly and giving feedback
Format: Lecture with modeled behavior by speaker and role-play in pairs
Content: Identifying educational goals, methods of evaluation, and criteria for effective formative and summative feedback
Session 3: Q&A panel with residents identified as excellent teachers
Format: Resident panel answers anonymous questions raised by students
Content: Specific to the students’ questions
Session 4: Small group discussions and role-playing
Format: Discussion and role-play in groups of 6-8 students with 1-2 resident leaders per group
Content: Clinical scenarios provide opportunity to practice teaching skills
The course was elective from 2000-2002 and mandatory from 2003-2005. Overall course ratings from 2000-2005 had a mean of 4.4 out of 5 (5= excellent, 1=poor) from 224 completed student questionnaires (62% response rate). The 2004 class was surveyed at the end of their intern year, and 84% of students agreed that the course helped them prepare for their role as teacher (n=45, response rate 60%).
Questions for discussion:
1) Should a “teaching to teach” course be mandatory in undergraduate medical education? If so, when should the course occur and for how many classroom hours?
2) Do you agree with the overall content of the sessions? Are there any topics that should be omitted, added, or modified?
3) Other than as mentioned in the discussion, how could future research seek to objectively measure whether or not the course produces improved teaching in medical interns?
Source:
Haber, RJ, Bardach, NS, Vedantha, R, et al. Preparing fourth-year medical students to teach during internship. J Gen Intern Med. 2006; 21: 518-520.
I find it interesting that medical training has stuck to the old models, particularly interns teaching medical students. While there’s merit on the pressure of having to teach, it also has some downsides, particularly if the new intern has not had training on teaching. I speak only from a patient and family perspective, which many times has been frustrating, as the intern is limited in knowledge and experience as well.